Individual provider Active NPI

Michael Maher Kattula, DO

  • Cardiovascular Disease Physician
  • Dearborn, MI
National Provider Identifier
1679140008
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
5151015062 Issued in MI
Practice address
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone
(313) 593-7000
NPI assigned
Jun 4, 2021
Last updated
Jun 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 5151015062 MI
Cardiovascular Disease Physician 207RC0000X 5151015062 MI Primary
Internal Medicine Physician 207R00000X 1891702833 MI

Addresses

Primary practice location

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Mailing address

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210908002028 MI Order and Referring Only - Cardiovascular Disease (Cardiology)Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5991101446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1891702833MIMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: mkattula600482@direct.hfhs.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1679140008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATTULA",
        "first_name": "MICHAEL",
        "middle_name": "MAHER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-04",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5151015062",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "5151015062",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "1891702833",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.